Provider Demographics
NPI:1154376200
Name:WESTIN, GEORGE W JR (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:WESTIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2488 N CALIFORNIA ST
Mailing Address - Street 2:ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5508
Mailing Address - Country:US
Mailing Address - Phone:209-948-3333
Mailing Address - Fax:209-948-2665
Practice Address - Street 1:2488 N CALIFORNIA ST
Practice Address - Street 2:ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5508
Practice Address - Country:US
Practice Address - Phone:209-948-3333
Practice Address - Fax:209-948-2665
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG44484207X00000X, 207XS0114X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0368640001OtherDMERC
200010334OtherRR MEDICARE
CGP159090OtherCGP
195690700OtherUSDL
CAZZZ71793ZMedicaid
CGP159090OtherCGP
CAZZZ71793ZMedicaid